Distortion Product Otoacoustic Emission (DPOAE) as an Appropriate Tool in Assessment of Otoprotective Effects of Antioxidants in Noise-Induced Hearing Loss (NIHL)

A phase I/IIa safety and efficacy trial of intratympanic gamma-secretase inhibitor as a regenerative drug treatment for sensorineural hearing loss

Inhibition of Notch signalling with a gamma-secretase inhibitor (GSI) induces mammalian hair cell regeneration and partial hearing restoration. In this proof-of-concept Phase I/IIa multiple-ascending dose open-label trial (ISRCTN59733689), adults with mild-moderate sensorineural hearing loss received 3 intratympanic injections of GSI LY3056480, in 1 ear over 2 weeks. Phase I primary outcome was safety and tolerability. Phase lla primary outcome was change from baseline to 12 weeks in average pure-tone air conduction threshold across 2,4,8 kHz. Secondary outcomes included this outcome at 6 weeks and change from baseline to 6 and 12 weeks in pure-tone thresholds at individual frequencies, speech reception thresholds (SRTs), Distortion Product Otoacoustic Emissions (DPOAE) amplitudes, Signal to Noise Ratios (SNRs) and distribution of categories normal, present-abnormal, absent and Hearing Handicap Inventory for Adults/Elderly (HHIA/E). In Phase I (N = 15, 1 site) there were no severe nor serious adverse events. In Phase IIa (N = 44, 3 sites) the average pure-tone threshold across 2,4,8 kHz did not change from baseline to 6 and 12 weeks (estimated change -0.87 dB; 95% CI -2.37 to 0.63; P = 0.252 and -0.46 dB; 95% CI -1.94 to 1.03; P = 0.545, respectively), nor did the means of secondary measures. DPOAE amplitudes, SNRs and distribution of categories did not change from baseline to 6 and 12 weeks, nor did SRTs and HHIA/E scores. Intratympanic delivery of LY3056480 is safe and well-tolerated; the trial's primary endpoint was not met.

Otoprotective Effects of Quercetin Against Oxidative Damage in the Rat's Cochlea Induced by Noise and Silver Nanoparticles

The aim of this study was to investigate the otoprotective effects of Quercetin (Que) against both noise-induced hearing loss (NIHL) and the ototoxicity of silver nanoparticles (SNPs) in rats. Forty-two male Wistar rats were divided into seven groups (n = 6): control, SNPs, Que (100 mg/kg) plus SNPs (100 mg/kg), noise (104 dB), Que plus noise, noise plus SNPs, and noise plus Que plus SNPs. In the weight change results, there was no significant difference between the groups exposed to noise plus SNPs and SNPs compared to the control group. However, animals had significant changes in DPOAE amplitude at 1 and 3 days post-exposure when compared to baseline. Additionally, the DPOAE value of rats administered with Que plus SNPs was higher than in all other groups. Que also decreased the levels of TACT, MDA, IL-6, TNF-α, and NOX3 in the groups exposed to noise and SNPs and increased the SOD level and expression of myosin heavy chain VII (MYH7) and β-tubulin III (TUBB3) proteins. Furthermore, Que decreased structural changes in the animals' cochlea. Our findings indicate that pretreatment with Que efficiently counteracted the adverse effects of noise and SNPs on inner hair cell, outer hair cell, and nerve cells, which are responsible for high-frequency perception.

Effect of antioxidant supplementation on the auditory threshold in sensorineural hearing loss: a meta-analysis

INTRODUCTION

Hearing loss is conceptualized as any impairment of the ability to hear and/or detect speech or environment sounds, regardless of cause, type, or degree. It may occur at different stages of life; during pregnancy or childbirth, in childhood, adulthood or old age. It should be noted that aging is the most common cause of sensorineural hearing loss followed by noise-induced hearing loss, and both are closely related to the formation of reactive oxygen species. Dietary antioxidant supplementation has been employed as a therapeutic strategy to prevent and/or delay the risks of major human diseases.

OBJECTIVE

To assess randomized clinical trials to determine the effect of antioxidant supplementation on the auditory thresholds in patients of different age groups with sensorineural hearing loss.

METHODS

This systematic review consisted of a search in the following databases: MEDLINE, CENTRAL, ScienceDirect, Scopus, Web of Science, LILACS, SciELO and ClinicalTrials.gov. Additionally, the gray literature was also searched. The search strategy included terms related to the intervention (antioxidant supplementation), primary outcome (sensorineural hearing loss), as well as terms related to randomized clinical trials to improve search sensitivity.

RESULTS

Based on 977 potentially relevant records identified through the search in the databases, ten full-text publications were retrieved for further evaluation. The increase in threshold at the 4kHz frequency was statistically higher in the control group (1.89 [1.01-2.78], p<0.0001) when compared to the NAC group and the ginseng group, whereas at 6kHz, the threshold increase was higher in the control group (1.42 [-1.14-3.97], p=0.28), but no statistically significant differences were found between groups.

CONCLUSION

Ginseng was the antioxidant agent that showed the best effect in preventing auditory threshold worsening at the frequency of 4kHz, but not at 6kHz in patients with sensorineural hearing loss caused by exposure to high sound pressure levels. There was no improvement in the thresholds with vitamin E supplementation.

Modeling signal-to-noise ratio of otoacoustic emissions in workers exposed to different industrial noise levels

Introduction:

Noise is considered as the most common cause of harmful physical effects in the workplace. A sound that is generated from within the inner ear is known as an otoacoustic emission (OAE). Distortion-product otoacoustic emissions (DPOAEs) assess evoked emission and hearing capacity. The aim of this study was to assess the signal-to-noise ratio in different frequencies and at different times of the shift work in workers exposed to various levels of noise. It was also aimed to provide a statistical model for signal-to-noise ratio (SNR) of OAEs in different frequencies based on the two variables of sound pressure level (SPL) and exposure time.

Materials and Methods:

This case–control study was conducted on 45 workers during autumn 2014. The workers were divided into three groups based on the level of noise exposure. The SNR was measured in frequencies of 1000, 2000, 3000, 4000, and 6000 Hz in both ears, and in three different time intervals during the shift work. According to the inclusion criterion, SNR of 6 dB or greater was included in the study. The analysis was performed using repeated measurements of analysis of variance, spearman correlation coefficient, and paired samples t-test.

Results:

The results showed that there was no statistically significant difference between the three exposed groups in terms of the mean values of SNR (P > 0.05). Only in signal pressure levels of 88 dBA with an interval time of 10:30–11:00 AM, there was a statistically significant difference between the right and left ears with the mean SNR values of 3000 frequency (P = 0.038). The SPL had a significant effect on the SNR in both the right and left ears (P = 0.023, P = 0.041). The effect of the duration of measurement on the SNR was statistically significant in both the right and left ears (P = 0.027, P < 0.001).

Conclusion:

The findings of this study demonstrated that after noise exposure during the shift, SNR of OAEs reduced from the beginning to the end of the shift.